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ANH-Intl Covid-19 information tracker - Week 23



Emergence of SARS-CoV-2 through recombination and strong purifying selection

Authors: Li X et al

Publication date: 29 May 2020

Journal: Science Advances

DOI: 10.1126/sciadv.abb9153

COVID-19 has become a global pandemic caused by the novel coronavirus SARS-CoV-2. Understanding the origins of SARS-CoV-2 is critical for deterring future zoonosis, discovering new drugs, and developing a vaccine. We show evidence of strong purifying selection around the receptor binding motif (RBM) in the spike and other genes among bat, pangolin, and human coronaviruses, suggesting similar evolutionary constraints in different host species. We also demonstrate that SARS-CoV-2’s entire RBM was introduced through recombination with coronaviruses from pangolins, possibly a critical step in the evolution of SARS-CoV-2’s ability to infect humans. Similar purifying selection in different host species, together with frequent recombination among coronaviruses, suggest a common evolutionary mechanism that could lead to new emerging human coronaviruses.

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In silico comparison of spike protein-ACE2 binding affinities across species; significance for the possible origin of the SARS-CoV-2 virus

Authors: Piplani S et al

Publication date: 13 May 2020

Journal: arXiv.org preprint

DOI: arXiv:2005.06199

The devastating impact of the COVID19 pandemic caused by SARS coronavirus 2 (SARSCoV2) has raised important questions on the origins of this virus, the mechanisms of any zoonotic transfer from exotic animals to humans, whether companion animals or those used for commercial purposes can act as reservoirs for infection, and the reasons for the large variations in susceptibilities across animal species. Traditional lab-based methods will ultimately answer many of these questions but take considerable time. In silico modeling methods provide the opportunity to rapidly generate information on newly emerged pathogens to aid countermeasure development and also to predict potential future behaviors. We used a structural homology modeling approach to characterize the SARSCoV2 spike protein and predict its binding strength to the human ACE2 receptor. We then explored the possible transmission path by which SARSCoV2 might have crossed to humans by constructing models of ACE2 receptors of relevant species, and calculating the binding energy of SARSCoV2 spike protein to each. Notably, SARSCoV2 spike protein had the highest overall binding energy for human ACE2, greater than all the other tested species including bat, the postulated source of the virus. This indicates that SARSCoV2 is a highly adapted human pathogen. Of the species studied, the next highest binding affinity after human was pangolin, which is most likely explained by a process of convergent evolution. Binding of SARSCoV2 for dog and cat ACE2 was similar to affinity for bat ACE2, all being lower than for human ACE2, and is consistent with only occasional observations of infections of these domestic animals. Overall, the data indicates that SARSCoV2 is uniquely adapted to infect humans, raising questions as to whether it arose in nature by a rare chance event or whether its origins lie elsewhere.

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SARS-CoV-2 is well adapted for humans. What does this mean for re-emergence?

Authors: Zhan SH et al

Publication date: 02 May 2020

Journal: bioRxiv preprint

DOI: 10.1101/2020.05.01.073262

In a side-by-side comparison of evolutionary dynamics between the 2019/2020 SARS-CoV-2 and the 2003 SARS-CoV, we were surprised to find that SARS-CoV-2 resembles SARS-CoV in the late phase of the 2003 epidemic after SARS-CoV had developed several advantageous adaptations for human transmission. Our observations suggest that by the time SARS-CoV-2 was first detected in late 2019, it was already pre-adapted to human transmission to an extent similar to late epidemic SARS-CoV. However, no precursors or branches of evolution stemming from a less human-adapted SARS-CoV-2-like virus have been detected. The sudden appearance of a highly infectious SARS-CoV-2 presents a major cause for concern that should motivate stronger international efforts to identify the source and prevent near future re-emergence. Any existing pools of SARS-CoV-2 progenitors would be particularly dangerous if similarly well adapted for human transmission. To look for clues regarding intermediate hosts, we analyze recent key findings relating to how SARS-CoV-2 could have evolved and adapted for human transmission, and examine the environmental samples from the Wuhan Huanan seafood market. Importantly, the market samples are genetically identical to human SARS-CoV-2 isolates and were therefore most likely from human sources. We conclude by describing and advocating for measured and effective approaches implemented in the 2002-2004 SARS outbreaks to identify lingering population(s) of progenitor virus.

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COVID-19 cytokine storm: The anger of inflammation

Authors: Mahmudpour M et al

Publication date: 30 May 2020

Journal: Cytokine

DOI: 10.1016/j.cyto.2020.155151

Patients with COVID-19 who require ICU admission might have the cytokine storm. It is a state of out-of-control release of a variety of inflammatory cytokines. The molecular mechanism of the cytokine storm has not been explored extensively yet. The attachment of SARS-CoV-2 spike glycoprotein with angiotensin-converting enzyme 2 (ACE2), as its cellular receptor, triggers complex molecular events that leads to hyperinflammation. Four molecular axes that may be involved in SARS-CoV-2 driven inflammatory cytokine overproduction are addressed in this work. The virus-mediated down-regulation of ACE2 causes a burst of inflammatory cytokine release through dysregulation of the renin-angiotensin-aldosterone system (ACE/angiotensin II/AT1R axis), attenuation of Mas receptor (ACE2/MasR axis), increased activation of [des-Arg9]-bradykinin (ACE2/bradykinin B1R/DABK axis), and activation of the complement system including C5a and C5b-9 components. The molecular clarification of these axes will elucidate an array of therapeutic strategies to confront the cytokine storm in order to prevent and treat COVID-19 associated acute respiratory distress syndrome.

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“The ancient and the new”: is there an interaction between cytomegalovirus and SARS-CoV-2 infection?

Author: Paul Moss

Publication date: 27 May 2020

Journal: Immunity & Ageing

DOI: 10.1186/s12979-020-00185-x

The SARS-CoV-2 pandemic represents one of the greatest infectious challenges to humanity in recent history. One of the striking features of infection is the heterogeneous clinical response with worse outcomes observed in older patients and those with underlying health conditions. To date the potential impact of previous infection history has been poorly investigated as a potential determinant of risk. Cytomegalovirus (CMV), a persistent herpesvirus infection whose prevalence increases with age, is a major modulator of immune function and several observations suggest that infection might act to influence clinical outcome following SARS-CoV-2 infection. In particular, CMV is associated with the acceleration of immune senescence and has been linked to a range of cardiovascular and metabolic disorders. This review addresses mechanisms by which cytomegalovirus infection may act to worsen the clinical outcome of SARS-CoV-2 infection, discusses how these potential links could be investigated, and assesses the potential significance of any findings that emerge.

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Covid-19 patients

The neurological manifestations of COVID-19: a review article

Authors: Niazkar HR et al

Publication date: 01 June 2020

Journal: Neurological Sciences

DOI: 10.1007/s10072-020-04486-3

Results: Various neurological manifestations have been reported in the literature associated with COVID-19, which in the current study are classified into Central Nervous System (CNS) related manifestations including headache, dizziness, impaired consciousness, acute cerebrovascular disease, epilepsy, and Peripheral Nervous System (PNS) related manifestations such as hyposmia/anosmia, hypogeusia/ageusia, muscle pain, and Guillain-Barre syndrome.

Conclusion: During the current context of COVID-19 pandemic, physicians should be aware of wide spectrum of neurological COVID-19 sign and symptoms for early diagnosis and isolation of patients. In this regard, COVID-19 has been associated with many neurological manifestations such as confusion, anosmia, and ageusia. Also, various evidences support the possible CNS roles in the COVID-19 pathophysiology. In this regard, further investigation of CNS involvement of SARS-COV-2 is suggested.

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UK report on 9347 patients critically ill with COVID-19 

Institution: Intensive Care National Audit & Research Centre (ICNARC)

Publication date: 29 May 2020


Obesity is associated with worse outcomes in COVID‐19: Analysis of Early Data From New York City

Authors: Hajifathalian K et al

Publication date: 29 May 2020

Journal: Obesity

DOI: 10.1002/oby.22923

Objective: The 2019 novel coronavirus disease (COVID‐19) has triggered a rapidly‐expanding global pandemic in which patients exhibit a wide spectrum of disease severity. Given the high prevalence of obesity in the United States, we hypothesized that the presence of obesity may play a role in the clinical course of COVID‐19 patients.

Methods: This is a retrospective review of adult patients admitted with confirmed SARS‐CoV‐2. Demographics, clinical characteristics, laboratory data, and clinical outcomes were abstracted. BMI (kg/m2) was analyzed with regard to a composite outcome of ICU admission or death, and intubation rate.

Results: 770 patients were included (61% male, mean age 63.5 yrs). Obese patients were more likely to present with fever, cough and shortness of breath. Obesity was also associated with a significantly higher rate of ICU admission or death (RR = 1.58, p = 0.002) even after adjusting for age, race and troponin level.

Conclusions: Obese patients had an increased risk of critical illness leading to ICU admission or death compared to normal weight individuals. This study confirms that obesity is a major risk factor for COVID‐19 disease severity, significantly impacting disease presentation and critical care requirements.

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Obesity and risk of COVID-19: analysis of UK Biobank

Authors: Thomas Yates and Cameron Razieh

Publication date: 28 May 2020

Journal: Primary Care Diabetes

DOI: 10.1016/j.pcd.2020.05.011

Whilst emerging evidence has suggested that those with cardiometabolic diseases are at higher risk of severe COVID-19 and resulting complications, less is known about the relative importance of related lifestyle factors. Obesity in particular is associated with impaired pulmonary function, a suppressed immune system and has been identified as a risk factor in previous infectious out- breaks [1]. Obesity also appears to be prevalent in subjects with COVID-19 [1,2]. However, as recently highlighted, there is a lack of information regarding the nature of association between body mass index (BMI) and COVID-19 [3].

In order to inform this area, we investigated the association between obesity and laboratory confirmed COVID-19 within UK Biobank (application number 36371). Our hypothesis was that BMI and waist circumference would be independently associated with COVID-19.

UK Biobank (https://www.ukbiobank.ac.uk/) is a large prospective cohort of 502,543 middle-aged adults. Assessments were conducted between March 2006 and July 2010. UK Biobank data are linked to national SARS-CoV-2 laboratory test data through Public Health England (PHE). Data provided included specimen origin (hospital inpatient indicating severe COVID-19 vs other settings). Data were available for the period 16th March 2020 to 3rd May 2020.

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Endogenous Deficiency of Glutathione as the Most Likely Cause of Serious Manifestations and Death in COVID-19 Patients

Author: Alexey Polonikov

Publication date: 28 May 2020

Journal: ACS Infectious Diseases

DOI: 10.1021/acsinfecdis.0c00288

Higher rates of serious illness and death from coronavirus SARS-CoV-2 (COVID-19) infection among older people and those who have comorbidities suggest that age- and disease-related biological processes make such individuals more sensitive to environmental stress factors including infectious agents like coronavirus SARS-CoV-2. Specifically, impaired redox homeostasis and associated oxidative stress appear to be important biological processes that may account for increased individual susceptibility to diverse environmental insults. The aim of this Viewpoint is to justify (1) the crucial roles of glutathione in determining individual responsiveness to COVID-19 infection and disease pathogenesis and (2) the feasibility of using glutathione as a means for the treatment and prevention of COVID-19 illness. The hypothesis that glutathione deficiency is the most plausible explanation for serious manifestation and death in COVID-19 patients was proposed on the basis of an exhaustive literature analysis and observations. The hypothesis unravels the mysteries of epidemiological data on the risk factors determining serious manifestations of COVID-19 infection and the high risk of death and opens real opportunities for effective treatment and prevention of the disease.

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Hydrogen peroxide and viral infections: a literature review with research hypothesis definition in relation to the current covid-19 pandemic

Authors: Arturo Armone Caruso, Antonio Del Prete and Antonio Ivan Lazzarino

Publication date: 01 June 2020

Journal: Medical Hypotheses

DOI: 10.1016/j.mehy.2020.109910

We reviewed the literature concerning the innate response from nasal and oral epithelial cells and their reaction to hydrogen peroxide (H2O2). Hydrogen peroxide is produced physiologically by oral bacteria and plays a significant role in the balance of oral microecology since it is an important antimicrobial agent. In the epithelial cells, the enzyme superoxide dismutase catalyzes a reaction leading from hydrogen peroxide to the ion superoxide. The induced oxidative stress stimulates a local innate response via activation of the toll-like receptors and the NF-κB. Those kinds of reactions are also activated by viral infections. Virus-induced oxidative stress plays an important role in the regulation of the host immune system and the specific oxidant-sensitive pathway is one of the effective strategies against viral infections. Therefore, nose/mouth/throat washing with hydrogen peroxide may enhance those local innate responses to viral infections and help protect against the current coronavirus pandemic. We strongly encourage the rapid development of randomized controlled trials in both SARS-CoV-2 positive and negative subjects to test the preliminary findings from the in-vitro and in-vivo observational studies that we identified.

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Withanone and caffeic acid phenethyl ester are predicted to interact with main protease (Mpro) of SARS-CoV-2 and inhibit its activity

Authors: Kuma V et al

Publication date: 01 June 2020

Journal: Journal of Biomolecular Structure and Dynamics

DOI: 10.1080/07391102.2020.1772108

The recent novel coronavirus, Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2/2019-nCoV) has caused a large number of deaths around the globe. There is an urgent need to understand this new virus and develop prophylactic and therapeutic drugs. Since drug development is an expensive, intense and time-consuming path, timely repurposing of the existing drugs is often explored wherein the research avenues including genomics, bioinformatics, molecular modeling approaches offer valuable strengths. Here, we have examined the binding potential of Withaferin-A (Wi-A), Withanone (Wi-N) (active withanolides of Ashwagandha) and Caffeic Acid Phenethyl Ester (CAPE, bioactive ingredient of propolis) to a highly conserved protein, Mpro of SARS-CoV-2. We found that Wi-N and CAPE, but not Wi-A, bind to the substrate-binding pocket of SARS-CoV-2 Mpro with efficacy and binding energies equivalent to an already claimed N3 protease inhibitor. Similar to N3 inhibitor, Wi-N and CAPE were interacting with the highly conserved residues of the proteases of coronaviruses. The binding stability of these molecules was further analyzed using molecular dynamics simulations. The binding free energies calculated using MM/GBSA for N3 inhibitor, CAPE and Wi-N were also comparable. Data presented here predicted that these natural compounds may possess the potential to inhibit the functional activity of SARS-CoV-2 protease (an essential protein for virus survival), and hence (i) may connect to save time and cost required for designing/development, and initial screening for anti-COVID drugs, (ii) may offer some therapeutic value for the management of novel fatal coronavirus disease, (iii) warrants prioritized further validation in the laboratory and clinical tests.

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Dietary therapy and herbal medicine for COVID-19 prevention: A review and perspective

Authors: Suraphan Panyod, Chi-Tang Ho and Lee-Yan Sheen

Publication date: 30 May 2020

Journal: Journal of Traditional and Complementary Medicine

DOI: 10.1016/j.jtcme.2020.05.004

A novel coronavirus disease (COVID-19), transmitted from humans to humans, has rapidly become the pandemic responsible for the current global health crisis. COVID-19 is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which is said to be of zoonotic origin. This review describes the etiology and signs and symptoms as well as the current allopathic therapy for COVID-19. Additionally, findings of previous studies on the immunomodulatory effects and antiviral activities of particular foods and herbs on influenza virus and coronaviruses have been collated, with the aim of promoting the use of dietary therapy and herbal medicine as COVID-19 preventive therapies, while specific drugs and vaccines are yet to be discovered or are still under development. The volume of existing reports is irrefutable evidence that foods and herbs possess a potential antiviral ability against SARS-CoV-2 and can prevent COVID-19. Foods and herbs could be used as dietary or complementary therapy to prevent infection and strengthen immunity, as antiviral agents for masks, as disinfectants to curb aerosol transmission, or as sanitizing agents to disinfect surfaces. However, these hypotheses need to be experimentally verified for SARS-CoV-2 and COVID-19 patients.

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Analysis on herbal medicines utilized for treatment of COVID-19

Authors: Luo L et al

Publication date: 27 May 2020

Journal: Acta Phamaceutica Sinica B

DOI: 10.1016/j.apsb.2020.05.007

As coronavirus disease 2019 (COVID-19) pandemic poses a substantial global public health threat, traditional Chinese medicine (TCM) was used in 91.50% of the COVID-19 cases in China, showing encouraging results in improving symptom management and reducing the deterioration, mortality, and recurrence rates. A total of 166 modified herbal formulae consisting of 179 single herbal medicines were collected for treating COVID-19 in China. Glycyrrhizae Radix et Rhizome, Scutellariae Radix, and Armeniacae Semen Amarum are the most frequently utilized in clinics, most of which are antipyretic (47, 26.26%), expectorant and cough-suppressing (22, 12.29%), and dampness-resolving (21, 11.73%) from traditional descriptions. A total of 1212 chemical components containing β-sitosterol, stigmasterol, and quercetin were primarily selected. Additionally, using complex system entropy and unsupervised hierarchical clustering, 8 core herbal combinations and 10 new formulae emerged as potentially useful candidates for COVID-19. Finally, following scaffold analysis, self-organizing mapping (SOM) and cluster analysis, 12 clusters of molecules yielded 8 pharmacophore families of structures that were further screened as pharmacological targets in human metabolic pathways for inhibiting coronavirus. This article aims to make more easily accessible and share historical herbal knowledge used in contemporary treatments in a modern manner to assist researchers contain the global spread of COVID-19.

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Vitamin D and COVID-19

Author: French National Academy of Medicine

Publication date: 22 May 2020

Journal: Bulletin de L’Academie Nationale de Medicine

DOI: 10.1016/j.banm.2020.05.098

Vitamin D cannot be considered as a preventive or a curative treatment for CoV-2 SARS infection. However, by mitigating the inflammatory storm and its consequences, it could be considered as an adjunct to any form of therapy.

The National Academy of Medicine:

  • points out that the administration of vitamin D per os is a simple and inexpensive measure, that is reimbursed by the French National Health Insurance;
  • confirms its recommendation to ensure vitamin D sup- plementation in the French population in a 2012 report [2];
  • recommends the rapid serum vitamin D (i.e. 25 OHD) test- ing in people over 60 years of age with COVID-19, and a loading dose of 50,000 to 100,000 IU in case of deficiency, which could help limit respiratory complications;
  • recommends vitamin D supplementation of 800 to 1000 IU/day in people under 60, as soon as the diagnosis of COVID-19 is confirmed.

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Control measures

Physical distancing, face masks, and eye protection to prevent person-to-person transmission of SARS-CoV-2 and COVID-19: a systematic review and meta-analysis

Authors: Chu DK, MD et al

Publication date: 01 June 2020

Journal: The Lancet

DOI: 10.1016/S0140-6736(20)31142-9

Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causes COVID-19 and is spread person-to-person through close contact. We aimed to investigate the effects of physical distance, face masks, and eye protection on virus transmission in health-care and non-health-care (eg, community) settings.

Methods: We did a systematic review and meta-analysis to investigate the optimum distance for avoiding person-to-person virus transmission and to assess the use of face masks and eye protection to prevent transmission of viruses. We obtained data for SARS-CoV-2 and the betacoronaviruses that cause severe acute respiratory syndrome, and Middle East respiratory syndrome from 21 standard WHO-specific and COVID-19-specific sources. We searched these data sources from database inception to May 3, 2020, with no restriction by language, for comparative studies and for contextual factors of acceptability, feasibility, resource use, and equity. We screened records, extracted data, and assessed risk of bias in duplicate. We did frequentist and Bayesian meta-analyses and random-effects meta-regressions. We rated the certainty of evidence according to Cochrane methods and the GRADE approach. This study is registered with PROSPERO, CRD42020177047.

Findings: Our search identified 172 observational studies across 16 countries and six continents, with no randomised controlled trials and 44 relevant comparative studies in health-care and non-health-care settings (n=25 697 patients). Transmission of viruses was lower with physical distancing of 1 m or more, compared with a distance of less than 1 m (n=10 736, pooled adjusted odds ratio [aOR] 0·18, 95% CI 0·09 to 0·38; risk difference [RD] −10·2%, 95% CI −11·5 to −7·5; moderate certainty); protection was increased as distance was lengthened (change in relative risk [RR] 2·02 per m; pinteraction=0·041; moderate certainty). Face mask use could result in a large reduction in risk of infection (n=2647; aOR 0·15, 95% CI 0·07 to 0·34, RD −14·3%, −15·9 to −10·7; low certainty), with stronger associations with N95 or similar respirators compared with disposable surgical masks or similar (eg, reusable 12–16-layer cotton masks; pinteraction=0·090; posterior probability >95%, low certainty). Eye protection also was associated with less infection (n=3713; aOR 0·22, 95% CI 0·12 to 0·39, RD −10·6%, 95% CI −12·5 to −7·7; low certainty). Unadjusted studies and subgroup and sensitivity analyses showed similar findings.

Interpretation: The findings of this systematic review and meta-analysis support physical distancing of 1 m or more and provide quantitative estimates for models and contact tracing to inform policy. Optimum use of face masks, respirators, and eye protection in public and health-care settings should be informed by these findings and contextual factors. Robust randomised trials are needed to better inform the evidence for these interventions, but this systematic appraisal of currently best available evidence might inform interim guidance.

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Predicting infectious SARS-CoV-2 from diagnostic samples

Authors: Bullard J, MD et al

Publication date: 22 May 2020

Journal: Clinical Infectious Diseases

DOI: 10.1093/cid/ciaa638

Background: RT-PCR has become the primary method to diagnose viral diseases, including SARS-CoV-2. RT-PCR detects RNA, not infectious virus, thus its ability to determine duration of infectivity of patients is limited. Infectivity is a critical determinant in informing public health guidelines/interventions. Our goal was to determine the relationship between E gene SARS-CoV-2 RT-PCR cycle threshold (Ct) values from respiratory samples, symptom onset to test (STT) and infectivity in cell culture.

Methods: In this retrospective cross-sectional study, we took SARS-CoV-2 RT-PCR confirmed positive samples and determined their ability to infect Vero cell lines.

Results: Ninety RT-PCR SARS-CoV-2 positive samples were incubated on Vero cells. Twenty-six samples (28.9%) demonstrated viral growth. Median TCID50/ml was 1780 (282-8511). There was no growth in samples with a Ct > 24 or STT > 8 days. Multivariate logistic regression using positive viral culture as a binary predictor variable, STT and Ct demonstrated an odds ratio for positive viral culture of 0.64 (95% CI 0.49-0.84, p<0.001) for every one unit increase in Ct. Area under the receiver operating characteristic curve for Ct vs. positive culture was OR 0.91 (95% CI 0.85-0.97, p<0.001), with 97% specificity obtained at a Ct of >24.

Conclusions: SARS-CoV-2 Vero cell infectivity was only observed for RT-PCR Ct < 24 and STT < 8 days. Infectivity of patients with Ct >24 and duration of symptoms >8 days may be low. This information can inform public health policy and guide clinical, infection control and occupational health decisions. Further studies of larger size are needed.

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Food as Medicine: A Possible Preventive Measure Against Coronavirus Disease (COVID-19)

Authors: Fan Y et al

Publication date: 28 May 2020

Journal: Phytotherapy Research

DOI: 10.1002/ptr.6770

The recent and ongoing outbreak of coronavirus disease (COVID‐19) is a huge global challenge. The outbreak, which first occurred in Wuhan City, Hubei Province, China and then rapidly spread to other provinces and to more than 200 countries abroad, has been declared a global pandemic by the World Health Organization (WHO). Those with compromised immune systems and/or existing respiratory, metabolic or cardiac problems are more susceptible to the infection and are at higher risk of serious illness or even death. The present review was designed to report important functional food plants with immunomodulatory and anti‐viral properties. Data on medicinal food plants was retrieved and downloaded from English‐language journals using online search engines. The functional food plants herein documented might not only enhance the immune system and cure respiratory tract infections but can also greatly impact the overall health of the general public. As many people in the world are now confined to their homes, inclusion of these easily accessible plants in the daily diet may help to strengthen the immune system and guard against infection by SARS‐CoV‐2. This might reduce the risk of COVID‐19 and initiate a rapid recovery in cases of SARS‐CoV‐2 infection.

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Covid-19: “Staggering number” of extra deaths in community is not explained by covid-19

Publication date: 13 May 2020

Source: BMJ News

Only a third of the excess deaths seen in the community in England and Wales can be explained by covid-19, new data have shown.

The Office for National Statistics (ONS) data,1 which cover deaths in hospitals, care homes, private homes, hospices, and elsewhere, show that 6035 people died as a result of suspected or confirmed covid-19 infection in England and Wales in the week ending 1 May 2020 (where deaths were registered up to 9 May), a decline of 2202 from the previous week.

Although the number of deaths in care homes has fallen for the second week in a row, more covid related deaths are being reported in care homes than in hospitals and are tailing off more slowly.

However, David Spiegelhalter, chair of the Winton Centre for Risk and Evidence Communication at the University of Cambridge, said that covid-19 did not explain the high number of deaths taking place in the community.

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Psychosocial Impact

Psychosocial impact of COVID-19

Authors: Dubney S et al

Publication date: 27 May 2020

Journal: Elsevier Public Health Emergency Collection

DOI: 10.1016/j.dsx.2020.05.035

Background: Along with its high infectivity and fatality rates, the 2019 Corona Virus Disease (COVID-19) has caused universal psychosocial impact by causing mass hysteria, economic burden and financial losses. Mass fear of COVID-19, termed as “coronaphobia”, has generated a plethora of psychiatric manifestations across the different strata of the society. So, this review has been undertaken to define psychosocial impact of COVID-19.

Results: Disease itself multitude by forced quarantine to combat COVID-19 applied by nationwide lockdowns can produce acute panic, anxiety, obsessive behaviors, hoarding, paranoia, and depression, and post-traumatic stress disorder (PTSD) in the long run. These have been fueled by an “infodemic” spread via different platforms social media. Outbursts of racism, stigmatization, and xenophobia against particular communities are also being widely reported. Nevertheless, frontline healthcare workers are at higher-risk of contracting the disease as well as experiencing adverse psychological outcomes in form of burnout, anxiety, fear of transmitting infection, feeling of incompatibility, depression, increased substance-dependence, and PTSD. Community-based mitigation programs to combat COVID-19 will disrupt children's usual lifestyle and may cause florid mental distress. The psychosocial aspects of older people, their caregivers, psychiatric patients and marginalized communities are affected by this pandemic in different ways and need special attention.

Conclusion: For better dealing with these psychosocial issues of different strata of the society, psychosocial crisis prevention and intervention models should be urgently developed by the government, health care personnel and other stakeholders. Apt application of internet services, technology and social media to curb both pandemic and infodemic needs to be instigated. Psychosocial preparedness by setting up mental organizations specific for future pandemics is certainly necessary.

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Test, trace and track

[UK] NHS test and trace: how it works

Publication date: 27 May 2020

Source: UK Government

The NHS test and trace service:

  • ensures that anyone who develops symptoms of coronavirus (COVID-19) can quickly be tested to find out if they have the virus, and also includes targeted asymptomatic testing of NHS and social care staff and care home residents
  • helps trace close recent contacts of anyone who tests positive for coronavirus and, if necessary, notifies them that they must self-isolate at home to help stop the spread of the virus

We are introducing this service to help return life more to normal, in a way that is safe and protects our NHS and social care. The service will allow us to trace the spread of the virus and isolate new infections and play a vital role in giving us early warning if the virus is increasing again, locally or nationally.

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Pandemic planning

COVID-19 Pandemic Planning Scenarios

Publication date: 20 May 2020

Source: Centers for Disease Control and Prevention

CDC and the Office of the Assistant Secretary for Preparedness and Responseexternal icon (ASPR) have developed five COVID-19 Pandemic Planning Scenarios that are designed to help inform decisions by modelers and public health officials who utilize mathematical modeling. The planning scenarios are being used by mathematical modelers throughout the Federal government.  Models developed using the data provided in the planning scenarios can help evaluate the potential effects of different community mitigation strategies (e.g., social distancing).  The planning scenarios may also be useful to hospital administrators in assessing resource needs and can be used in conjunction with the COVID-19Surge Tool.

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Social impact

The impact of sex and gender in the COVID-19 pandemic

Author: Directorate-General for Research and Innovation (European Commission)

Publication date: May 2020

Source: Publications Office of the European Union

This case study, developed by the European Commission’s H2020 Expert Group to update and expand "Gendered Innovations/ Innovation through Gender", examines the impact of sex and gender in the current COVID-19 pandemic, looking more particularly at such key issues as sex differences in immune responses, dosing and sex-specific side effects of vaccines and therapeutics, gender-specific risk factors

(e.g. for healthcare workers and caregivers), gender-sensitive prevention campaigns, as well as the gender-specific socioeconomic burden of public safety measures. Although infectious diseases can affect everyone, sex and gender can significantly impact immune responses and the course of the disease in the human body. Importantly, the biological impacts of the pandemic intersect with broader social and systemic challenges, such as limited healthcare, and economic and logistic resources. In the case of COVID-19, current worldwide statistics show more men than women dying of acute infection, while women are projected to suffer more than men from the health, economic and social consequences of the pandemic in the long term. Innovative solutions beyond health, such as economic re-entry strategies, product development and AI solutions also need to consider sex and gender.

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Media – Science related


COVID-19 Vaccine Researchers Mindful of Immune Enhancement

Author: Katarina Zimmer

Publication date: 26 May 2020

Source: The Scientist

Most people who contract the dengue virus, a mosquito-borne RNA virus, experience mild symptoms or none at all. In some cases, it can cause a severe illness known as hemorrhagic fever, with bleeding, abnormal blood clotting, and leaky blood vessels that can sometimes lead to a precipitous drop in blood pressure and circulatory collapse. Curiously, in the 1960s, US army scientists in Thailand noticed this life-threatening condition occurred most frequently in two populations: first-time infected babies born to mothers who were immune to dengue, and children who had once experienced a mild or asymptomatic infection, and later contracted the virus a second time. A scary scenario began to crystalize: a second infection was sometimes worse than the first.

A series of studies in cells, animals, and people eventually gave rise to a possible explanation: antibodies created during a first-time infection could, under very specific circumstances, end up enhancing the disease rather than protecting against subsequent infections. Researchers called this “antibody-dependent enhancement,” or ADE.

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Disputed Hydroxychloroquine Study Brings Scrutiny to Surgisphere

Author: Catherine Offord

Publication date: 30 May 2020

Source: The Scientist

Surgisphere Corporation, the company that supplied data for a controversial study on the health risks of hydroxychloroquine for COVID-19 patients published in The Lancet last week (May 22), has found itself in the spotlight after researchers raised questions about the dataset.

The Lancet study, which lists Surgisphere founder and CEO Sapan Desai as one of four coauthors, reported harmful effects tied to the anti-malaria drug hydroxychloroquine among patients with COVID-19. In response to the findings, the World Health Organization (WHO) and several other health organizations stopped or suspended clinical trials of the drug while they look more closely into the compound’s safety. 

The database used for the Lancet study, which the paper states includes 96,032 patients from 671 hospitals across six continents, is accessible only by Surgisphere. But in the week since the paper’s publication, concerns about that dataset have swirled on social media, on the post-publication discussion website PubPeer, and in newspapers. 

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Lab-free COVID-19 test trialled in London hospitals

Author: Joanna Wilson

Publication date: 28 May 2020

Source: Imperial College, London

DnaNudge’s MHRA-approved rapid COVID-19 test is now rolling out in urgent patient care settings across London hospitals.

DnaNudge’s rapid, lab-free COVID-19 test, developed by Imperial College London’s Regius Professor of Engineering Chris Toumazou, offers gold-standard accuracy and sample-to-result in around an hour. The test is now being rolled out in urgent patient care settings following approval for clinical use by the Medicines and Healthcare Products Regulatory Agency (MHRA), granted at the end of April after successful patient trials. The DnaNudge test achieves sensitivity of 98% and specificity of 100%. 

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Media – Reporting


Wastewater testing gains traction as a Covid-19 early warning system

Author: Sharon Begley

Publication date: 28 May 2020

Source: STAT

What only a month ago had been merely an intriguing laboratory finding about analyzing wastewater to detect the virus that causes Covid-19 has quickly leapt to the threshold of real-world use.

With swab tests still plagued by capacity issues, inaccuracy, and slow turnaround, testing wastewater for the novel coronavirus’ genetic signature could give communities a faster way to spot a rebound in cases — as soon as this fall.

“There is real hope that this can be a sensitive, early warning” if, as officials ease social distancing measures, Covid-19 begins to spread again, said Peter Grevatt, CEO of the nonprofit Water Research Foundation. “Several labs have achieved a proof-of-concept in terms of demonstrating the ability to detect the RNA [genetic material] of the virus in wastewater.” Studies in the U.S. and the Netherlands, among others, have shown you can pick up a signal about a week before the first clinical case.

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Endemic disease

Coronavirus may never go away, even with a vaccine

Authors: Willian Wan and Carolyn U Johnson

Publication date: 27 May 2020

Source: The Washington Post

There’s a good chance the coronavirus will never go away.

Even after a vaccine is discovered and deployed, the coronavirus will likely remain for decades to come, circulating among the world’s population.

Experts call such diseases endemic — stubbornly resisting efforts to stamp them out. Think measles, HIV, chickenpox.

It is a daunting proposition — a coronavirus-tinged world without a foreseeable end. But experts in epidemiology, disaster planning and vaccine development say embracing that reality is crucial to the next phase of America’s pandemic response. The long-term nature of covid-19, they say, should serve as a call to arms for the public, a road map for the trillions of dollars Congress is spending and a fixed navigational point for the nation’s current, chaotic state-by-state patchwork strategy.

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Norway health chief: lockdown was not needed to tame Covid

Author: Fraser Nelson

Publication date: 27 May 2020

Source: The Spectator

Norway is assembling a picture of what happened before lockdown and its latest discovery is pretty significant. It is using observed data – hospital figures, infection numbers and so on – to construct a picture of what was happening in March. At the time, no one really knew. It was feared that virus was rampant with each person infecting two or three others – and only lockdown could get this exponential growth rate (the so-called R number) down to a safe level of 1. This was the hypothesis advanced in various graphs by Imperial College London for Britain, Norway and several European countries.

But the Norwegian public health authority has published a report with a striking conclusion: the virus was never spreading as fast as had been feared and was already on the way out when lockdown was ordered. ‘It looks as if the effective reproduction rate had already dropped to around 1.1 when the most comprehensive measures were implemented on 12 March, and that there would not be much to push it down below 1… We have seen in retrospect that the infection was on its way down.’ Here’s the graph, with the R-number on the right-hand scale:

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COVID Coercion: Boris Johnson's Psychological Attack on the UK Public

Author: Mike Robinson

Publication date: 14 May 2020

Source: UK Column

Coercion: the practice of forcing another party to act in an involuntary manner by use of threats or force.

Over the course of the Covid-19 ‘crisis’, scientific advice to the UK Government has been co-ordinated by the Scientific Advisory Group for Emergencies (SAGE). SAGE is co-chaired by Sir Patrick Vallance (the Government Chief Science Advisor) and Professor Chris Whitty (the Chief Medical Officer).

We have already seen how SAGE has used external advisors to help direct the medical and social response. But the UK government also claims that “many issues around the coronavirus response relate to behaviour”.

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Pandemic’s overall death toll in U.S. likely surpassed 100,000 weeks ago

Authors: Andrew Ba Tran,  Leslie Shapiro and  Emma Brown

Publication date: 30 May 2020

Source: The Washington Post

The number of people reported to have died of the novel coronavirus in the United States surpassed 100,000 this week, a grim marker of lives lost directly to the disease, but an analysis of overall deaths during the pandemic shows that the nation probably reached a similar terrible milestone three weeks ago.

Between March 1 and May 9, the nation recorded an estimated 101,600 excess deaths, or deaths beyond the number that would normally be expected for that time of year, according to an analysis conducted for The Washington Post by a research team led by the Yale School of Public Health. That figure reflects about 26,000 more fatalities than were attributed to covid-19 on death certificates during that period, according to federal data.

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The way ‘Covid deaths’ are being counted is a national scandal

Author: Dr John Lee

Publication date: 30 May 2020

Source: The Spectator

As a pathologist, I’m used to people thinking that my job mainly involves dealing with death. But nothing could be further from the truth. That is why I and many of my colleagues are so dismayed by changes introduced during the coronavirus epidemic which mean that pathology has not been able to play the role that it should have in helping to understand this new disease.

The word ‘pathology’ tends to conjure up images of body bags, mortuaries and murder investigations. ‘Ho ho,’ people say, ‘your patients can’t answer back.’ They imagine days spent trudging across fields to reach murder scenes, Silent Witness-style, and nights sifting through arcane evidence to catch the perpetrators. And a rare type of pathologist — the forensic pathologist — does indeed do that.

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The CDC confirms remarkably low coronavirus death rate. Where is the media?

Author: Daniel Horowitz

Publication date: 22 May 2020

Source: Conservative Review

Most people are more likely to wind up six feet under because of almost anything else under the sun other than COVID-19.

The CDC just came out with a report that should be earth-shattering to the narrative of the political class, yet it will go into the thick pile of vital data and information about the virus that is not getting out to the public. For the first time, the CDC has attempted to offer a real estimate of the overall death rate for COVID-19, and under its most likely scenario, the number is 0.26%. Officials estimate a 0.4% fatality rate among those who are symptomatic and project a 35% rate of asymptomatic cases among those infected, which drops the overall infection fatality rate (IFR) to just 0.26% — almost exactly where Stanford researchers pegged it a month ago.

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Scientists hunt pandemic hotspots in race to test vaccines

Author: Katie Kelland and Julie Steenhuysen

Publication date: 01 June 2020

Source: Reuters

Scientists in Europe and the United States say the relative success of draconian lockdown and social distancing policies in some areas and countries means virus transmission rates may be at such low levels that there is not enough disease circulating to truly test potential vaccines.

They may need to look further afield, to pandemic hotspots in Africa and Latin America, to get convincing results.

“Ironically, if we’re really successful using public health measures to stamp out the hot spots of viral infection, it will be harder to test the vaccine,” said Francis Collins, director of the National Institutes of Health in the United States.

A vaccine is seen as essential to ending a pandemic that has killed nearly 370,000 people and infected more than 6 million so far, with world leaders looking at inoculation as the only real way to restart their stalled economies.

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COVID-19 Human Challenge Trials

Source: 1DaySooner

Human challenge trials deliberately expose participants to infection, in order to study diseases and test vaccines or treatments. They have been used for influenza, malaria, typhoid, dengue fever, and cholera. Researchers are exploring whether human challenge trials could speed up the development of a vaccine for COVID-19, saving thousands or even millions of lives.

Website allows you to sign up to become a volunteer for human challenge trials for covid-19.

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A Low-Carb Strategy for Fighting the Pandemic’s Toll

Author: Nina Teicholz

Publication date: 31 May 2020

Source: Nutrition Coalition

The coronavirus has added a brutal exclamation point to America’s pervasive ill health. Americans with obesity, diabetes, heart disease and other diet-related diseases are about three times more likely to suffer worsened outcomes from Covid-19, including death. Had we flattened the still-rising curves of these conditions, it’s quite possible that our fight against the virus would today look very different.

To combat this and future pandemics, we need to talk about not only the masks that go over our mouths but the food that goes into them. Next  month, an expert committee will issue its advisory report on the federal government’s official dietary guidelines for the next five years. First published in 1980, the guidelines are meant to encourage healthy eating, but they have self-evidently failed to stem the ever-rising rates of obesity, diabetes and other chronic diseases in the U.S.

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Social Impacts

Spain approves national minimum income scheme

Author: Kate Ng

Publication date: 29 May 2020

Source:  The Independent

Spain’s cabinet has approved the creation of a national minimum income, according to a government spokesperson.

Deputy Prime Minister Pablo Iglesias told a news conference on Friday the creation of a minimum income worth €462 (£416.92) a month will target some 850,000 households or 2.5 million people.

The government would pay the monthly stipend and top up existing revenue for people earning less so that they receive at least that minimum amount every month, he said.

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Is COVID-19 the Tipping Point for Mitigating the Mental Health Crisis?

Authors: Brittany N Rudd PhD and Rinad Beidas PhD

Publication date: 28 May 2020

Source: Thrive Global

On October 31, 2019, we spent blissful days with our young children, getting ready for a night of revelry. One of us spent the day singing “Baby Shark” to a 10-month-old who learned to crawl in his shark costume at the ideal moment. The other took 4-year-old Elsa and 6-year-old Lego Ninjago out for a spin to see who could get the most candy. We both ended our evenings sitting on our stoops in Philadelphia enjoying the crisp fall weather, passing out candy to neighbors, and celebrating the beauty of community and rituals.

Earlier that day, we discussed with colleagues on Twitter the importance of technology as a vehicle to deliver mental health prevention and treatment to overcome the global mental health crisis. This discussion inspired a forthcoming commentary in JMIR Mental Health on improving public mental health by harnessing the synergy of people and technology.

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